MHLDA Service Specification

Supported Living Provision  

Mental Health, Learning Disability and Autism Adults, and Older Adults

Service Overview

This specification outlines the delivery of person-centred supported living services for individuals with Mental Health (MH), Learning Disabilities (LD), and Autism Spectrum Conditions (ASC) across low, medium, and high support levels. Services are designed to promote independence, safeguard wellbeing, and enable community participation, with adjustments for developmental stage (Adult, Older Adult).

Aims and Objectives

• Enable independence through personalised care and support.
• Promote safety via proportionate risk management.
• Facilitate inclusion in education, work, and community life.
• Support health & wellbeing with proactive and preventative approaches.
• Reduce reliance on inpatient or institutional settings.
• Ensure smooth transitions between life stages (e.g. Adult to Older Adult services).

Service User Groups

• Mental Health – Severe and enduring mental illness, complex trauma, co-morbid conditions.
• Learning Disabilities – Mild to profound LD, with or without additional needs.
• Autism Spectrum Conditions – Including those with sensory, communication, and behavioural needs.
• Co-occurring conditions – e.g. substance misuse, physical health needs.

Support Levels Low Support

• Support less than 10 hours per week, often visiting support.
• Focus: tenancy sustainment, budgeting, daily living skills, low-level emotional support.

Medium Support

• Support between 10–37 hours per week, mix of visiting and on-site staff.
• Focus: structured routines, community access, self-care, social skills, relapse prevention.

High Support

• 24/7 staffing (waking nights/sleep-ins), potentially 1:1, 2:1 or higher-level staffing support.
• Focus on intensive support for safety, complex behavioural needs, crisis prevention, and ongoing therapeutic interventions.

Age-Specific Adjustments

Adults

• Employment or vocational training support.
• Skills for independent living.
• Support for relationships and parenting (if relevant).

Older Adults

• Cognitive impairment and dementia-aware practice.
• Falls prevention and physical health monitoring.
• End-of-life planning and palliative support where needed.

Service Model

• Person-Centred Planning – Co-produced support plans, goals, and outcomes.
• Positive Behaviour Support (PBS) – Proactive, evidence-based strategies.
• Dynamic Risk Assessment – Continuous monitoring and adaptation.
• Multi-Disciplinary Working – Integrated with health, social care, education, and voluntary sectors.
• Outcome Measurement – Progress tracked against agreed wellbeing and independence markers.

Staffing Skills and Training Offered

• Appropriate staff ratios based on assessed need.
• Trained in MH, LD, ASC awareness, PBS, safeguarding, and trauma-informed care.
• Access to specialist clinical support (e.g., psychology, OT).
• Regular supervision, reflective practice, and CPD.

Accommodation Standards

• Safe, accessible, and age-appropriate environments.
• Individual tenancies or licenses to promote rights and independence.
• Adaptations for sensory and physical needs.
• Communal spaces for social interaction where appropriate.

Safeguarding and Governance

• Robust safeguarding procedures for adults and older adult at risk.
• Incident reporting, learning, and improvement systems.
• Compliance with CQC regulatory standards.
• Regular quality audits and service reviews.

Outcomes

• Increased independence and life skills.
• Improved physical and mental health.
• Sustained accommodation and community participation.
• Reduction in crisis episodes, hospital admissions, or restrictive interventions.

Complex and Forensic Client Needs

The service will also cater for individuals with significant forensic history and complex risk profiles. This includes those who may present with multiple and overlapping needs requiring robust safeguarding, multi-agency coordination, and specialist interventions.

• Clients with significant forensic history and high risk to self or others.
• Individuals with complex and challenging needs, including those with histories of serial offending.
• Dual diagnosis – co-occurring substance misuse and mental illness.
• Non-concordance with prescribed medication and treatment plans.
• Individuals subject to Court of Protection orders or other legal restrictions.
• Persons known to Multi-Agency Public Protection Arrangements (MAPPA).
• Registered sex offenders requiring specialist risk management strategies.
• Individuals with a history of serious criminal behaviours, including violence and sexual offences.

Services for these client groups will be delivered with enhanced staff training, close supervision, and joint working with police, probation, courts, and specialist forensic mental health services. Dynamic risk assessment processes will be embedded to ensure safety of the individual, staff, and the public.